CMS Formulary

Displaying 9871-9880 of 1611142 results.
ID: 9871
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9872
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9873
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9874
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 9875
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 9876
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 9877
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9878
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9879
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 9880
Formulary ID: 00021003
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0